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Similaire à Community and enterprise department community grant application form 2011
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Community and enterprise department community grant application form 2011
- 1. COMMUNITY AND ENTERPRISE DEPARTMENT COMMUNITY GRANT APPLICATION FORM 2011 Closing Date 31st January 2011 Date Received:- Reference Number:- ALL APPLICATIONS ARE TO BE MADE TO: The Office of the Director of Community and Enterprise Block 4, Floor 1e Civic Offices, Wood Quay. Dublin 8 By 5pm 31st January 2011.
- 2. 2 SECTION 1 – GROUP/ ORGANISATION DETAILS Name of Organisation __________________________________________________________ Address __________________________________________________________ __________________________________________________________ Postal District __________________________________________________________ Tax Clearance Cert/Charity Status Number (if applicable) : ___________________________ Expiry Date: __________________ Is your Organisation affiliated to the Dublin Community Forum? Yes / No ( Please circle which is appropriate) Contact Name __________________________________________________________ Telephone No. ___________________________________ E-mail ___________________________________ Bank Details of Organisation Account Name ____________________________________________________________________ Bank Address ____________________________________________________________________ Sort Code ____________________________________________________________________ Account Number ___________________________________________________________________
- 3. 3 COMMUNITY GRANT APPLICATION FORM SECTION 2 - PURPOSE OF GRANT Note: The City Council will support community activities at neighbourhood level promoted by voluntary groups eg. festivals, environmental activities, older persons activities, heritage/historical projects etc. The City Council under its Community Grants Scheme will not support sports activities eg. football clubs nor will it provide funding for the employment of staff. For further advice and information please discuss your proposal with your local community development staff member. What is the purpose of the Grant? ___________________________________________________________________________________ Who is going to participate in this project and how many participants will be involved? ___________________________________________________________________________________ Where will this project take place? ___________________________________________________________________________________ ___________________________________________________________________________________ Commencement Date ____________________ Completion Date__________________________ Description of the Activity __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________
- 4. 4 COMMUNITY GRANT APPLICATION FORM SECTION 3 - FUNDING How much is the overall cost of the project? _________________________________ How much is being applied for under the DCC Community Grants Scheme? _____________________________________ Please provide details of other funding already received for the project/event: Name of Organisation: _______________________________________________________ Amount Received: _______________________________________________________ Date Received: _______________________________________________________ Please provide details of potential income: Name of Organisation: ________________________________________________________ Amount: ________________________________________________________ SECTION 4 - DECLARATION DECLARATION I declare that the information supplied is accurate and complete. I understand that all information provided in respect of the Grant Application will be held electronically and may be made available to other Dublin City Council Departments as appropriate. It should be noted that the Freedom of Information Act applies to all records held by Dublin City Council. (The application must be signed by either the Chairperson, Secretary or Treasurer of the organisation making the submission). Name (please print) ___________________________ Date ________________________ Signed ______________________ Chairperson/Secretary/ Treasurer (delete as appropriate)